Prognostic significance of tumor volume in locally recurrent nasopharyngeal carcinoma treated with salvage intensity-modulated radiotherapy.
Prognostic significance of tumor volume in locally recurrent nasopharyngeal carcinoma treated with salvage intensity-modulated radiotherapy.
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DOI：
10.1371/journal.pone.0125351
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发表时间：
2015
期刊：
影响因子：
3.7
通讯作者：
Han F
中科院分区：
文献类型：
--
作者：
Xiao W;Liu S;Tian Y;Guan Y;Huang S;Lin C;Zhao C;Lu T;Han F
目的探讨大体肿瘤体积(TV)对局部复发、非转移性鼻咽癌患者预后的预测价值。对2001~2012年间291例局部复发、非转移性鼻咽癌患者行保存性调强放疗的临床资料进行回顾性分析。分析TV与复发T分级的相关性。进行生存分析。计算接收器工作特性(ROC)曲线以识别电视的截止点。采用Akaike信息标准和Harrell‘s和谐指数(c-index)检验预后价值。随着复发T分级的推进，Tv的中位数显著增加(P<；0.001)。整个队列的5年总存活率为33.2%。多因素分析显示，TV是影响无远处转移生存率(危险性比=1.013，P=0.003)、总生存率(危险性比=1.015，P&t；0.001)和毒性相关死亡(危险性比=1.014，P&t；0.001)的独立负面预后因素。TV<；22 cm~3和TV≥22 cm~3患者的5年总生存率分别为63.1%和20.8%(P<；0.001)。在TV<；22cm3患者中，局部衰竭是主要的死亡原因。在TV≥22cm3患者中，远处转移率较高，且发生在局部复发后的短期内；同时，放射损伤变得更加常见，导致该组患者一半的死亡。Akaike信息准则和c指数分析表明，与TV相结合时，递归T分类的预测能力有所提高。我们的数据表明，TV是预测局部复发、非转移鼻咽癌患者在挽救调强放疗后的远处转移、总生存期和毒性相关死亡的重要预后因素。在为这些患者设计个性化的抢救治疗时，应该考虑电视。对于局部复发的巨大肿瘤患者，可能需要减轻放射治疗的压力，以利于全身治疗或最佳支持性护理。
To evaluate the prognostic value of gross tumor volume (TV) in patients with locally recurrent, nonmetastatic nasopharyngeal carcinoma. Between 2001 and 2012, 291 consecutive patients with locally recurrent, nonmetastatic nasopharyngeal carcinoma underwent salvage IMRT were retrospectively reviewed. The correlations between TV and recurrent T classification were analyzed. Survival analyses were performed. Receiver operating characteristic (ROC) curves were calculated to identify cut-off point of TV. The Akaike information criterion and Harrell’s concordance index (c-index) were utilized to test the prognostic value. The median TV significantly increased with advancing recurrent T classification (P<0.001). The 5-year overall survival rate was 33.2% for the entire cohort. On multivariate analysis, TV was an independent negative prognostic factor for distant metastasis-free survival (hazard ratio =1.013, P =0.003), overall survival (hazard ratio = 1.015, P<0.001) and toxicity-related death (hazard ratio = 1.014, P<0.001). The 5-year overall survival rates were 63.1% and 20.8% for patients with a TV < 22 cm3 and TV ≥22 cm3, respectively (P < 0.001). In patient with TV <22 cm3, locoregional failure is the leading cause of death. In patients with TV≥22 cm3, distant metastasis rate is higher and occurred within short term after local recurrence; meanwhile, radiation-induced injuries became more common and led to half of deaths in this group. The Akaike information criterion and c-index analyses indicated that the predictive ability of recurrent T classification improved when combined with TV. Our data suggests TV is a significant prognostic factor for predicting the distant metastasis, overall survival and toxicity-related death of patients with locally recurrent, nonmetastatic nasopharyngeal carcinoma after salvage IMRT. TV should be considered when designing personalized salvage treatments for these patients. For patients with bulky local recurrent tumor, radiation may need to be de-emphasized in favor of systemic treatment or best supportive care.
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DOI：
10.1002/hed.23010
发表时间：
2013-05-01
影响因子：
2.9
作者：
Wu, Zheng;Zeng, Rui-Fang;Huang, Shao-Min
通讯作者：
Huang, Shao-Min
原发肿瘤体积是否仍是鼻咽癌调强放射治疗的预后因素？
影响因子：
5.7
作者：
Guo, Rui;Sun, Ying;Ma, Jun
通讯作者：
Ma, Jun
DOI：
10.1016/s0360-3016(98)00323-x
发表时间：
1998-11-01
影响因子：
7
作者：
De Jaeger, K;Merlo, FM;Hill, RP
通讯作者：
Hill, RP
DOI：
10.2310/7070.2003.37253
发表时间：
2003-04-01
期刊：
JOURNAL OF OTOLARYNGOLOGY
影响因子：
--
作者：
Chang, CC;Chen, MK;Hwang, KL
通讯作者：
Hwang, KL
影响因子：
1.7
作者：
Sarisahin, Murat;Cila, Aysenur;Turen, Selahattin
通讯作者：
Turen, Selahattin